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Chronic thrombocytopenia of childhood: use of non-invasive methods in clinical evaluation

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Rajantie J, Javela K, Joutsi-Korhonen L, Kekomäki R. Chronic thrombocytopenia of childhood: use of non-invasive methods in clinical evaluation.

Eur J Haematol 2004: 72: 268–272. © Blackwell Munksgaard 2004. Abstract: Objectives

: An unselected group of 21 children with chronic thrombocytopenia was investigated to understand the patients’ platelet abnormality better. Methods

: Platelet counts, mean platelet volumes (MPV), membrane glycoproteins and Fcγ receptor type IIA (FcγRIIA) polymorphism H131R, reticulated platelets (%RP), antiplatelet antibodies and plasma thrombopoietin (TPO) were measured. Results

: Sixteen patients had idiopathic thrombocytopenic purpura (ITP) (group 1: platelets <50 × 109/L, n = 6; group 2: 50–99 × 109/L, n = 4; group 3: 100–149 × 109/L, n = 4; group 4: splenectomised patients with normal platelet counts, n = 2). Five patients had familial thrombocytopenia. Six healthy children were studied as a reference. In the 19 thrombocytopenic patients, the platelets were significantly larger and %RP and TPO levels were significantly higher than those in the controls. Increased megakaryocytosis at diagnosis was associated with larger MPV and higher %RP but not with platelet level or TPO. The %RP was remarkably high in all ITP patients of group 1 indicating a brisk production of platelets despite low peripheral count. In all patients with familial thrombocytopenia, TPO was increased suggesting that the syndrome was not because of defective TPO production. The distribution of FcγRIIA alleles in the patients was similar to that in the controls. Conclusions

: A combined application of %RP and TPO could be helpful in classifying patients with chronic thrombocytopenia into different categories. The observations may be of value in the clinical evaluation of ITP patients and lead to avoidance of invasive examinations at least in some patients.
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Keywords: children; reticulated platelets; thrombocytopenia; thrombopoietin

Document Type: Research Article

Affiliations: 1: Helsinki University Central Hospital, Jorvi Hospital, Espoo, Finland 2: Finnish Red Cross Blood Transfusion Service, Helsinki, Finland

Publication date: April 1, 2004

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